Medically reviewed by Dr Sin Yong · Last reviewed · 3 min read
Published 13 October 2026 · Reviewed by Dr Sin Yong
Boxcar scar is the term for a depressed acne scar with a flat floor and defined, near-vertical edges, so that it looks like a small box pressed into the skin. Boxcar scars are wider than ice-pick scars and sharper-edged than rolling scars, and they may be shallow or deep. Depth decides the tool: shallow boxcars are a surface problem, deep ones need an ablative column that reaches the scar floor.
Key facts
Shape
Flat floor, steep defined walls, round or oval outline
Depth
Shallow or deep; the depth, not the width, sets the treatment
Usually approached by
Fractional CO₂ resurfacing or RF microneedling; TCA CROSS for narrow, deep ones
Not
A tethered scar unless the base stays pinned on stretching, in which case subcision comes first
Where it fits
Boxcar scars are one of the three atrophic acne scar shapes graded in the Jacob classification, alongside ice-pick and rolling scars, and most scarred faces carry more than one type. On the acne scar treatment page Dr Sin Yong separates them by depth: shallow boxcar scars, fine textural scarring and post-acne marks can be treated with FSX Laser, which has a shorter recovery than S3; deep boxcar scars need the S3 Resurfacing Lift, multi-depth fractional CO₂ on the DEKA Tetra Pro that reaches the scar floor. A boxcar scar that stays pinned when the skin is stretched has a tethered component and is released by subcision before either laser is used.
Frequently Asked Questions
No. An ice-pick scar is a narrow, deep tract under about 2 mm across; a boxcar scar is wider, with a flat floor and defined edges. Ice-pick scars are treated focally with TCA CROSS, boxcar scars by resurfacing or RF microneedling according to depth.
Depth decides. Shallow boxcar scars suit FSX Laser, which has a shorter recovery than S3. Deep boxcar scars need the S3 Resurfacing Lift, a multi-depth fractional CO₂ protocol on the DEKA Tetra Pro. Many faces need both, on different scars.
References
Kumar N, et al. Effectiveness of radiofrequency microneedling in the treatment of dermatological conditions: a systematic review. Aesthetic Plast Surg. 2026. doi:10.1007/s00266-026-05834-y (PMID 42047762). source
Syder NC, Chen A, Elbuluk N. Radiofrequency and radiofrequency microneedling in skin of color: a review of usage, safety, and efficacy. Dermatol Surg. 2023;49:489. doi:10.1097/DSS.0000000000003733 (PMID 36826381). source
